Abstract
Background
Infrasternal mediastinoscopic surgery is a new alternative to the thoracoscopic approach for patients with anterior mediastinal masses.
Methods
We applied this technique to 18 thymectomies, one thymomectomy, and one cystectomy in a total of 20 patients with anterior mediastinal masses and then assessed the surgical results.
Results
Infrasternal mediastinoscopic surgery was accomplished in 18 of the 20 patients (90%). The pathological diagnoses included 13 Masaoka stage I thymomas, one stage II thymoma, two stage III thymomas, one thymic cyst, one pericardial cyst, one thymic granuloma, and one mature teratoma. Two patients with stage III thymoma required conversion to sternotomy, one for invasion into the innominate vein and the other for invasion into the pericardium. There was no surgically related mortality or complications in any patients.
Conclusion
Infrasternal mediastinoscopic surgery is safe and feasible for stage I thymoma and other benign tumors in the anterior mediastinum.
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References
TE Acuff MJ Mack WH Ryan RT Bowman MB Douthit (1993) ArticleTitleThoracoscopic thymoma resection. Ann Thorac Surg 55 562–563 Occurrence Handle1:STN:280:ByyC2Mbitl0%3D Occurrence Handle8431085
VJ DeFilippi DP Richman MK Ferguson (1994) ArticleTitleTranscervical thymectomy for myasthenia gravis. Ann Thorac Surg 57 194–197 Occurrence Handle1:STN:280:ByuC3cjgtlY%3D Occurrence Handle8279889
A Jaretzki RJ Barohn RM Ernstoff et al. (2000) ArticleTitleMyasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Neurology 55 16–23 Occurrence Handle10891897
A 3rd Jaretzki M Wolff (1988) ArticleTitle“Maximal” thymectomy for myasthenia gravis. Surgical anatomy and operative technique. J Thorac Cardiovasc Surg 96 711–716 Occurrence Handle3184965
T Kido K Hazama Y Inoue Y Tanaka T Takao (1999) ArticleTitleResection of anterior mediastinal masses through an infrasternal approach. Ann Thorac Surg 67 263–265 Occurrence Handle10.1016/S0003-4975(98)01210-7 Occurrence Handle1:STN:280:DyaK1M7osVektQ%3D%3D Occurrence Handle10086573
RJ Landreneau RD Dowling WM Castillo PF Ferson (1992) ArticleTitleThoracoscopic resection of an anterior mediastinal tumor. Ann Thorac Surg 54 142–144 Occurrence Handle1:STN:280:By2A3cvhtFE%3D Occurrence Handle1610226
MJ Mack RJ Landreneau AP Yim SR Hazelrigg GR Scruggs (1996) ArticleTitleResults of video-assisted thymectomy in patients with myasthenia gravis. J Thorac Cardiovasc Surg 112 1352–1360 Occurrence Handle1:STN:280:ByiD28fgtVI%3D Occurrence Handle8911334
A Masaoka Y Monden K Nakahara T Tanioka (1981) ArticleTitleFollow-up study of thymomas with special reference to their clinical stages. Cancer 48 2485–2492 Occurrence Handle1:STN:280:Bi2D2cfjslA%3D Occurrence Handle7296496
TC Mineo E Pompeo V Ambrogi (1997) ArticleTitleVideo-assisted thoracoscopic thymectomy: from the right or from the left? J Thorac Cardiovasc Surg 114 516–517
TC Mineo E Pompeo V Ambrogi AF Sabato G Bernardi CU Casciani (1996) ArticleTitleAdjuvant pneumomediastinum in thoracoscopic thymectomy for myasthenia gravis. Ann Thorac Surg 62 1210–1212 Occurrence Handle10.1016/0003-4975(96)00537-1 Occurrence Handle1:STN:280:BymH38%2Fkt1I%3D Occurrence Handle8823125
KH Moore PR McKenzie CW Kennedy BC McCaughan (2001) ArticleTitleThymoma: trends over time. Ann Thorac Surg 72 203–207 Occurrence Handle10.1016/S0003-4975(01)02633-9 Occurrence Handle1:STN:280:DC%2BD3Mvhs1altg%3D%3D Occurrence Handle11465180
JL Port RJ Ginsberg (2001) ArticleTitleSurgery for thymoma. Chest Surg Clin North Am 11 421–437 Occurrence Handle1:STN:280:DC%2BD38%2FhtlWrtw%3D%3D
DJ Sugarbaker (1993) ArticleTitleThoracoscopy in the management of anterior mediastinal masses. Ann Thorac Surg 56 653–656 Occurrence Handle1:STN:280:ByyA1MzjtFU%3D Occurrence Handle8379763
S Takeo T Sakada T Yano (2001) ArticleTitleVideo-assisted extended thymectomy in patients with thymoma by lifting the sternum. Ann Thorac Surg 71 1721–1723 Occurrence Handle10.1016/S0003-4975(00)02697-7 Occurrence Handle1:STN:280:DC%2BD3MzhtVChsg%3D%3D Occurrence Handle11383846
A Uchiyama S Shimizu H Murai S Kuroki M Okido M Tanaka (2001) ArticleTitleInfrasternal mediastinoscopic thymectomy in myasthenia gravis: surgical results in 23 patients. Ann Thorac Surg 72 1902–1906 Occurrence Handle10.1016/S0003-4975(01)03210-6 Occurrence Handle1:STN:280:DC%2BD38%2FmsVWnsw%3D%3D Occurrence Handle11789768
KB Wilkins E Sheikh R Green M Patel S George M Takano M Diener-West J Welsh S Howard F Askin GB Bulkley (1999) ArticleTitleClinical and pathologic predictors of survival in patients with thymoma. Ann Surg 230 562–574 Occurrence Handle10.1097/00000658-199910000-00012 Occurrence Handle1:STN:280:DyaK1MvltVGlsw%3D%3D Occurrence Handle10522726
AP Yim (1995) ArticleTitleVideo-assisted thoracoscopic management of anterior mediastinal masses. Preliminary experience and results. Surg Endosc 9 1184–1188 Occurrence Handle1:STN:280:BymC3s7ovFc%3D Occurrence Handle8553230
AP Yim (1996) ArticleTitleVideo-assisted thoracoscopic resection of anterior mediastinal masses. Int Surg 81 350–353
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Uchiyama, A., Shimizu, S., Murai, H. et al. Infrasternal mediastinoscopic surgery for anterior mediastinal masses. Surg Endosc 18, 843–846 (2004). https://doi.org/10.1007/s00464-003-8191-0
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DOI: https://doi.org/10.1007/s00464-003-8191-0